Pharmacology of Skin Cancer - Sweatman

Question 1

what is the MOA of Imiquimod (the primary MOA)

Answer 1

agonist for Toll Like Receptors, TLR 7 or 8

Question 2

What type of skin cancer is Imiquimod indicated for?

Answer 2

Basal Cell Carcinoma

Question 3

What is the route of administration of Imiquimod and why is this important?

Answer 3

it is applied topically
(go read over his slide about the specifics of application)
the rate of absorption and systemization of the drug is related to the concentration of the application and the surface area to which it is applied, and also how long the cream stays on the skin

Question 4

what is a key side effect of imiquimod, let’s say if you’re gonna be knocking boots later

Answer 4

it can compromise the integrity of barrier contraception - somehow it eats through condoms

Question 5

what is a general side effect of Imiquimod, and how should you counsel patients accordingly

Answer 5

increases photosensitivity - pts need to avoid direct sunlight to the treated area

Question 6

What is the Hedgehog inhibiting drug? name

Answer 6

Vismodegib

Question 7

what is an important side effect of Vismodegib, the hedgehog inhibitor

Answer 7

teratogenic -

male sperm also affected. so don’t jizz inside her

Question 8

why is Vismodegib, a headgehog inhibitor, teratogenic?

this is not necessarily for memorization, just a way to help remember why Vismodegib is teratogenic

Answer 8

hedgehog family of intercellular signaling proteins are key mediators in processes in embryonic development. Their activities are central to growth, patterning, and morphogenesis of many different regions within the body plans of vertebrates - so if you inhibit this pathway in the neonate, will fuck up development

Question 9

which type of skin cancer is there no targeted therapy?

Answer 9

squamous cell carcinoma

Question 10

what drug works by stimulating IL-2 mediated functions? what type of skin cancer is it used for?

Answer 10

Aldesleukin, used for melanoma

Question 11

what two drugs that we talked about require regular X-ray monitoring of patients - for pulmonary shit

Answer 11

Aldesleukin and INF-alpha

Question 12

What drug promotes T cell activation through the removal of negative regulatory influence from CTLA4

Answer 12

Ipilimumab

Question 13

what kind of skin cancer is Ipilimumab used for

Answer 13

melanoma

Question 14

what two drugs target PD1? what skin cancer are they used for?

Answer 14

Nivolumab and Pembolizumab

used for melanoma

Question 15

What is a common mutation seen in melanoma?

Answer 15

BRAF

Question 16

are tyrosine kinase inhibitors teratogenic?

Answer 16

yes

Question 17

the use of what drugs is predicated upon determining a BRAF V600E or V600K mutation prior to starting therapy?

Answer 17

Vemurafenib
Dabrafenib
(sorafenib, trametinib - although they do not explicitly target BRAF)

Question 18

in general, is genotyping required for use of kinase inhibitors

Answer 18

yes

Question 19

what is the target of Trametinib

Answer 19

MEK1 and MEK2

Question 20

In general, what are 4 ways resistance could arise to MAPK inhibitors? (think pathways)

Answer 20

accumulation of a new mutation during tumor proliferation
activation of ancillary pathways, either up or downstream of the targeted block
activation of bypass pathways
all that malarkey of pathway feedback - one pathway is active, downregulates others - if you block that pathway, then other pathways become more active

Question 21

What is the MOA of tirchloroacetic acid? what is it used to treat

Answer 21

causes a chemical peel

used to treat actinic keratosis

Question 22

is oxybenzone a chemical or filter type sunscreen

Answer 22

chemical

Question 23

for measuring efficacy of sunscreen, define the critical wavelength

Answer 23

CW represents the wavelength at which 90% of the absorbance curve resides

Question 24

what does the SPF labeling of a product denote?

Answer 24

its ability to protect the skin from sunburn

Question 25

what is the maximum SPF value that can be ascribed a sunscreen?

Answer 25

50+

Question 26

what sunscreen products can be labeled as “broadspectrum”

Answer 26

those that protect against both UV-A and UV-B light

Question 27

read over the sunscreen handout, he said there would be a question coming form that

Answer 27

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